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General NPI Number Information
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NPI Number | 1477765238
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Entity Type | Individual
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Provider Name | JEANETTE LEVINE MORRISON MD
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Gender | Female
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Dates
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Enumeration Date | 05/04/2007
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Last Update Date | 02/19/2009
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Provider Practice Location Address
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Address Line | 3333 GREEN BAY RD
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City | NORTH CHICAGO
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State | IL
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Zip | 60064-3037
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Country | US
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Telephone | 847-578-8646
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Fax |
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Provider Business Mailing Address
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Address Line | 880 SHOOTINGSTAR RD
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City | GRAYSLAKE
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State | IL
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Zip | 60030-3562
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Country | US
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Telephone | 847-548-8070
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 036093489
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License Number State | IL
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